To be competitive in fellowship match for IMGs, those factors matter the
most (in descending order)

1. Where you did your residency; most single important factor (sad but ture)
. People here are very snobby and judge you 80% from your pedigree. In a
way, it makes sense but it is sad for IMGs. For a bad community IM program,
it is almost impossible to match Cardiology or GI or any fellowship unless
somebody huge helps you. I know CMGs matched at MGH GI and Cards from
cummunity hospital with support from God in their field. This is
exceptionally rare.

2. Who write your letters of recommendation, in line with above example.

3. For research track, research background. If you have Nature, Science or
Cell level first author, it helps a great deal. If you carry your own grant,
you have already had your foot in the door. Middle level research without
own funding does not help much to get top notch fellowship because you are
competing with many US trained MD/PhD.

4. Again, Green card matters a great deal. H-1 status is a mark of evil in
fellowship match except a few community programs. J-1 is better for that
matter.

5. Interview: In my opinion, interview does not matter that much at all.
Everybody who has done IM residency, IMG or not, should have some
communication ability and personal skills. You can kill the opportunity with
very very bad interview but you will never win a spot with superp interview
. They know what they are looking for from you CV alone.

Anyway, ironically, little if anything to do with how well you do at your
residency. Everything is pretty much predetermined when you walk into your
residency.Do you best to get in a good residency if you want to do
competitive fellowship otherwise you have to pray for devine miracle given
current market.
--